الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
UGIB is common medical emergency presented to the ED with high morbidity and mortality. UGIB is defined as bleeding from any enteric source (esophagus, stomach, or duodenum) proximal to the ligament of Treitz. The UGIB patients present to the hospital by one or more of the following symptoms: hematemesis (bloody or coffee ground emesis) or melena. The etiology of UGIB is peptic ulcers, esophageal and gastric varices, gastritis and duodenitis, Mallory-Weiss tear, arteriovenous malformations, and malignancy.
In order to handle these patients, proper assessment and accurate risk stratification should be done rapidly in ED. Multiple risk scores have been proposed to help emergency physicians to triage the patients and to predict the clinical outcomes of UGIB patients so they can identify the high risk patients requiring immediate intervention and low risk patients who can be safely discharged. The most common clinical scores included in this study were GBS, AIMS65, PRS, and FRS.
The present study included 100 patients above the age of 18 years presented to the ED by acute UGIB symptoms. The aim of the work was to assess and compare the performance of the scores included in this study to predict the clinical outcomes including: mortality, rebleeding, ICU admission, the need of blood transfusion, endoscopic intervention, and length of hospital stay.
The results recorded were as follow:
• Males were two third of all the studded cases (65%).
• Over (60%) of patients were in the age of fifties and sixties.
• Most of our patients had liver disease (63%).
• 59% of the patients had hemoglobin level above 8gm/dl.
• 13% of the patients were admitted to the ICU.
• Upper endoscopy was done for 42% of the patients
• 22% of the patients were dead.
• The majority of patients (82%) were admitted for less than 7 days in the hospital.
• All the study scores were statistically significant with different levels of performance in predicting each clinical outcome.
• AIMS65 score was the best performing in prediction of mortality, rebleeding, and ICU admission only.
• Serum lactate at presentation and after resuscitation can be used as a predictor for outcome in cases of upper GI bleeding and not just hypovolemic shock.